**NOT PEER REVIEWED**
Possible risk factors for rehospitalization for trach dependent infants identified.
Akangire et al. (2017) conducted a retrospective cohort study examining 117 infants with tracheostomies who were followed until they were 2 years old. The study drew from a database associated with Children’s Mercy Hospital in Missouri. The authors examined readmissions and identified factors that were associated with increased risk of rehospitalization in these children. The most common cause of readmission was viral illnesses. The risk factors that were found to increase rehospitalization included tracheostomy dependence, ventilator dependence, inhaled steroid use, prolonged oxygen use, and equipment malfunction. The authors recognize limitations of their study, including that the database only had access to a single health care system and that they did not take into account socioeconomic status.
This is an interesting study that starts to identify factors that may increase risk of rehospitalization in trach- and vent-dependent infants. As this information comes from a database managed by a pulmonology clinic at a major medical center, their patients may be coming from far away, and their emergency care may not be completely represented here. Further studies are needed to address this as well as socioeconomic and demographic factors. In addition, the examination of protective factors and the impact of interventions such as home nursing, home visits, and other supports would be interesting for future studies.
Arda Hotz, MD
General Academic Pediatric Fellow, Complex Care Service, Boston Children’s Hospital
Akangire G et al. Factors leading to rehospitalization for tracheostomized and ventilator-dependent infants through 2 years of age. J of Perinatology. 2017 Apr 20, epub ahead of print. PMID: 28425979.